JUNE 21, 1912] 
tion in hospital work, in diagnosis, prog- 
nosis and treatment, and should be as 
closely affiliated with the hospital as are 
the clinical chairs. Those of you who have 
read ‘‘The Corner of Harley Street,’’® a 
most delightful series of letters by an Eng- 
lish consultant, may remember the words 
quoted by the author from a lecture of a 
brother consultant to postgraduates. Said 
the lecturer: 
Gentlemen, I should like the day to dawn when 
I could be met at the door of my hospital by a 
trained chemist, a trained bacteriologist, a trained 
pathologist, so that when I come to some compli- 
eated case I could say, ‘‘Chemist, a part of this 
problem is yours, take it and work it out. Bac- 
teriologist, perform your share in elucidating this 
difficulty. Pathologist, advance, and do likewise.’’ 
These are not idle words. Since Ziems- 
sen in the middle eighties established in 
Munich the principle of a clinical labora- 
tory in the hospital, the idea has spread 
rapidly, until now every hospital worthy 
of the name has its clinical laboratory for 
the routine procedures of diagnosis. But 
this is not sufficient. The clinical chief must 
have the close cooperation of his colleagues 
in the departments of pathology, bacteriol- 
ogy, physiology and chemistry, and the 
student likewise must have the outfits of 
these departments at hand to aid him in 
his clinical studies. It is no longer 
enough to depend on the simpler proced- 
ures for the examination of urine, sputum, 
blood and other body secretions and fluids. 
The transportation across the city of tissues 
or fluids for examination in the laborator- 
ies of the school can no longer be counte- 
nanced. The progress of modern medicine, 
especially in pathological chemistry and 
immunology, demands for the benefit of 
the patient as well as for the proper in- 
struction of the student, detailed and 
18¢<The Corner of Harley Street, being some 
Familiar Correspondence of Peter Harding, 
M.D.,’’? Houghton Mifflin Co., 1911. 
SCIENCE 
953 
oftentimes prolonged examinations under 
the hospital roof or at least within the 
boundaries of the hospital yard, and under 
the control not of assistants or internes, 
or dependent on occasional visits of a 
professor of pathology, bacteriology or 
chemistry, but under the constant super- 
vision of such experts who do their teach- 
ing and research in the hospital and con- 
tribute their share to the diagnosis, care 
and treatment of the ills of the patients. 
This is the ideal of social service in medi- 
cine, the goal of all effort in medical edu- 
cation and research; and it is not Utopian. 
Already the University of Toronto has 
transferred its departments of pathology, 
bacteriology and pathological chemistry 
to the grounds of the hospital which fur- 
nishes its clinical instruction. Here not 
only the elementary instruction is given, 
largely aided by an abundance of fresh 
material from the hospital, but each ad- 
vanced student serving as clinical clerk in 
the wards has always his desk, well- 
equipped locker and special outfit for the 
detailed investigation of his clinical ma- 
terial by laboratory methods, and more- 
over, has always at hand his teachers in the 
laboratory branches to aid him in his clin- 
ical investigations. It was my good for- 
tune recently to go over these departments 
with Professors Leathes and MacKenzie, 
who explained their workings to me. 
When I expressed my satisfaction at the 
ideal union of clinical and laboratory 
methods Professor Leathes said quietly, 
and as if there could be no other point of 
view, ‘‘ Yes, we expect a student working 
in the wards to use in diagnosis the meth- 
ods of pathological chemistry as he does 
his stethoscope.’’ Do you know what this 
means? It means that the amphitheater 
clinic and the didactic lecture are to follow 
the two-year and three-year course and 
that the methods and instruction of the 
